SeaSpine (SPNE) 10-Q 6 May 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	May 01, 2020
Document Documentand Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Trading Symbol	SPNE
Entity Registrant Name	SeaSpine Holdings Corporation
Entity Central Index Key	0001637761
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Emerging Growth Company	true
Entity Small Business	true
Entity Ex Transition Period	false
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		27,244,075

CONDENSED COMBINED STATEMENT OF

CONDENSED COMBINED STATEMENT OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Statement [Abstract]
Total revenue, net	$ 36,111	$ 36,150
Cost of goods sold	13,812	13,579
Gross profit	22,299	22,571
Selling and marketing	20,476	18,974
General and administrative	8,554	8,334
Research and development	3,895	3,512
Intangible amortization	792	792
Impairment of intangible assets	1,325	0
Total operating expenses	35,042	31,612
Operating loss	(12,743)	(9,041)
Other income, net	227	73
Loss before income taxes	(12,516)	(8,968)
Provision for income taxes	35	21
Net loss	$ (12,551)	$ (8,989)
Net loss per share, basic and diluted	$ (0.48)	$ (0.48)
Weighted average shares used to compute basic and diluted net loss per share	26,420	18,872

CONDENSED COMBINED STATEMENTS O

CONDENSED COMBINED STATEMENTS OF COMPREHENSIVE LOSS Statement - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net loss	$ (12,551)	$ (8,989)
Foreign currency translation adjustments	(164)	(169)
Debt Securities, Available-for-sale, Unrealized Gain (Loss)	190	11
Comprehensive loss	$ (12,525)	$ (9,147)

CONDENSED COMBINED BALANCE SHEE

CONDENSED COMBINED BALANCE SHEETS - USD ($)	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 80,006,000	$ 20,199,000
Short-term Investments	25,200,000	0
Trade accounts receivable, net of allowances of $90 and $111	20,005,000	24,902,000
Inventories, net	47,682,000	47,155,000
Prepaid expenses and other current assets	2,966,000	3,906,000
Total current assets	175,859,000	96,162,000
Property, plant and equipment, net	25,792,000	25,751,000
Operating Lease, Right-of-Use Asset	8,710,000	0
Intangible assets, net	16,761,000	19,173,000
Other assets	605,000	632,000
Total assets	227,727,000	141,718,000
Current liabilities:
Accounts payable, trade	11,046,000	7,448,000
Accrued compensation	4,194,000	7,879,000
Accrued commissions	5,824,000	7,843,000
Contingent consideration liabilities	1,959,000	1,864,000
Operating Lease, Liability, Current	2,095,000	0
Other accrued expenses and current liabilities	4,670,000	5,444,000
Total current liabilities	29,788,000	30,478,000
Contingent consideration liabilities, net of current portion	86,000	230,000
Operating Lease, Liability, Noncurrent	7,964,000	0
Other liabilities	0	1,250,000
Total liabilities	37,838,000	31,958,000
Commitments and contingencies
Stockholders' equity:
Preferred stock, $0.01 par value; 15,000 authorized; no shares issued and outstanding at March 31, 2020 and December 31, 2019	0	0
Common stock, $0.01 par value; 60,000 authorized; 27,237 and 19,124 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively	272,000	191,000
Additional paid-in capital	376,784,000	284,211,000
Accumulated other comprehensive income	1,460,000	1,434,000
Accumulated deficit	(188,627,000)	(176,076,000)
Total stockholders' equity	189,889,000	109,760,000
Total liabilities and stockholders' equity	$ 227,727,000	$ 141,718,000

CONDENSED COMBINED BALANCE SH_2

CONDENSED COMBINED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Allowance for trade accounts receivable	$ 90	$ 111
Preferred Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01
Preferred Stock, Shares Authorized	15,000,000	15,000,000
Preferred Stock, Shares Outstanding	0	0
Common Stock, Par or Stated Value Per Share	$ 0.01	$ 0.01
Common Stock, Shares Authorized	60,000,000	60,000,000
Common Stock, Shares, Issued	27,237,000	19,124,000
Common Stock, Shares, Outstanding	27,237,000	19,124,000

CONDENSED COMBINED STATEMENTS_2

CONDENSED COMBINED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
OPERATING ACTIVITIES:
Net loss	$ (12,551)	$ (8,989)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	2,608	2,770
Instrument replacement expense	379	548
Impairment of intangible assets	1,325	0
Other Asset Impairment Charges	234	30
Provision for excess and obsolete inventories	2,104	741
Amortization of debt issuance costs	19	19
Deferred income tax provision	14	6
Stock-based compensation	1,983	1,947
(Gain)/loss from change in fair value of contingent consideration liabilities	(16)	64
Non-cash lease expense, net	(40)	0
Changes in assets and liabilities:
Accounts receivable	4,853	(458)
Inventories	(2,354)	(2,890)
Prepaid expenses and other current assets	937	757
Other non-current assets	(7)	(1)
Accounts payable	3,458	3,782
Accrued commissions	(2,021)	(161)
Other accrued expenses and current liabilities	(3,628)	(3,423)
Other non-current liabilities	(7)	85
Net cash used in operating activities	(2,710)	(5,173)
INVESTING ACTIVITIES:
Purchases of property and equipment	(2,196)	(2,208)
Payments to Acquire Intangible Assets	850	0
Payments to Acquire Debt Securities, Available-for-sale	(25,007)	0
Proceeds from Sale and Maturity of Debt Securities, Available-for-sale	0	5,000
Net cash (used in) provided by investing activities	(28,053)	2,792
FINANCING ACTIVITIES:
Proceeds from issuance of common stock, net of offering costs- ATM transactions	91,622	0
Proceeds from exercise of stock options	902	143
Repurchases of common stock for income tax withheld upon vesting of restricted stock awards and restricted stock units	(1,855)	(1,849)
Payment of contingent consideration liabilities in connection with acquisition of business	(33)	(30)
Net cash provided by (used in) financing activities	90,636	(1,736)
Effect of exchange rate changes on cash and cash equivalents	(66)	(64)
Net change in cash and cash equivalents	59,807	(4,181)
Cash and cash equivalents at beginning of period	20,199	24,233
Cash and cash equivalents at end of period	80,006	20,052
Supplemental cash flow information
Interest Paid, Excluding Capitalized Interest, Operating Activities	38	38
Income Taxes Paid, Net	14	6
Non-cash investing activities:
Property and equipment in liabilities	$ 1,055	$ 1,891

CONDENSED COMBINED STATEMENT _2

CONDENSED COMBINED STATEMENT OF EQUITY Statement - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Retained Earnings [Member]
Beginning Balance, Shares, Outstanding at Dec. 31, 2018		18,669,000
Beginning Balance at Dec. 31, 2018	$ 142,085	$ 187	$ 277,096	$ 1,602	$ (136,800)
Net loss	(8,989)				(8,989)
Foreign currency translation adjustment	(169)			(169)
Debt Securities, Available-for-sale, Unrealized Gain (Loss)	11
Stock Issued During Period, Shares, Restricted Stock Award, Gross		216,000
Restricted stock issued	2	$ 2	0
Issuance of common stock- exercise of stock options		11,000
Issuance of common stock- exercise of stock options	143	$ 0	143
Repurchases of common stock for income tax withheld upon vesting of restricted stock awards and restricted stock units		0
Repurchases of common stock for income tax withheld upon vesting of restricted stock awards and restricted stock units	(1,851)		(1,851)
Stock-based compensation	1,947		1,947
Ending Balance, Shares, Outstanding at Mar. 31, 2019		18,896,000
Ending Balance at Mar. 31, 2019	$ 133,179	$ 189	277,335	1,444	(145,789)
Beginning Balance, Shares, Outstanding at Dec. 31, 2019	19,124,000	19,124,000
Beginning Balance at Dec. 31, 2019	$ 109,760	$ 191	284,211	1,434	(176,076)
Net loss	(12,551)
Foreign currency translation adjustment	(164)			(164)
Debt Securities, Available-for-sale, Unrealized Gain (Loss)	190
Stock Issued During Period, Shares, Restricted Stock Award, Gross		213,000
Restricted stock issued	2	$ 2
Issuance of common stock, net of offering costs- ATM transactions		7,820,000
Issuance of common stock, net of offering costs- ATM transactions	91,622	$ 78	91,544
Issuance of common stock- exercise of stock options		80,000
Issuance of common stock- exercise of stock options	902	$ 1	901
Repurchases of common stock for income tax withheld upon vesting of restricted stock awards and restricted stock units	(1,855)		(1,855)
Stock-based compensation	$ 1,983		1,983
Ending Balance, Shares, Outstanding at Mar. 31, 2020	27,237,000	27,237,000
Ending Balance at Mar. 31, 2020	$ 189,889	$ 272	$ 376,784	$ 1,460	$ (188,627)

BUSINESS

BUSINESS	3 Months Ended
	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BUSINESS	BUSINESS AND BASIS OF PRESENTATION Business SeaSpine Holdings Corporation was incorporated in Delaware on February 12, 2015 in connection with the spin-off of the orthobiologics and spinal implant business of Integra LifeSciences Holdings Corporation, a diversified medical technology company. The spin-off occurred on July 1, 2015. Unless the context indicates otherwise, (i) references to "SeaSpine" or the "Company" refer to SeaSpine Holdings Corporation and its wholly-owned subsidiaries, and (ii) references to "Integra" refer to Integra LifeSciences Holdings Corporation and its subsidiaries other than SeaSpine. Basis of Presentation and Principles of Consolidation The Company prepared the unaudited interim condensed consolidated financial statements included in this report in accordance with accounting principles generally accepted in the U.S. (GAAP) for interim financial information and the rules and regulations of the Securities and Exchange Commission (SEC) related to quarterly reports on Form 10-Q. The Company’s financial statements are presented on a consolidated basis. The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. Intercompany accounts and transactions have been eliminated in consolidation. The unaudited interim condensed consolidated financial statements do not include all information and disclosures required by GAAP for annual audited financial statements and should be read with the Company’s consolidated financial statements and notes thereto for the year ended December 31, 2019 included in the Company’s Annual Report on Form 10-K filed with the SEC. In the opinion of management, the unaudited interim condensed consolidated financial statements included in this report have been prepared on the same basis as the Company's audited consolidated financial statements and include all adjustments (consisting only of normal recurring adjustments) necessary for a fair statement of the financial position, results of operations, cash flows, and statement of equity for periods presented. The results for the three months ended March 31, 2020 are not necessarily indicative of the results expected for the full year. The condensed consolidated balance sheet as of December 31, 2019 was derived from the audited consolidated financial statements for the year ended December 31, 2019. Under current SEC rules, generally, a company qualifies as a "smaller reporting company" if it has a public float of less than $250 million as of the last business day of its most recently completed second fiscal quarter. If a company qualifies as a smaller reporting company on that date, it may elect to reflect that determination and use the smaller reporting company scaled disclosure accommodations in its subsequent SEC filings until the beginning of the first quarter of the fiscal year following the date it determines it does not qualify as a smaller reporting company. The Company's public float as of the last business day of its second fiscal quarter of 2019 was less than $250 million, and as such, the Company qualifies as a smaller reporting company, elected to reflect that determination and intends to use certain of the scaled disclosure accommodations in its SEC filings made during and for the year ended December 31, 2020. Concentration of Risk Integra and PcoMed, LLC (PcoMed) entered into a supply agreement in May 2013 (the Supply Agreement), which was subsequently assigned to the Company by Integra in May 2015. For the three months ending March 31, 2020, the sales of products incorporating the NanoMetalene® technology licensed and supplied to the Company pursuant to the Supply Agreement exceeded 10% of the Company's revenue. Pursuant to the Supply Agreement, PcoMed granted the Company a worldwide exclusive license to sell certain of its products treated with certain proprietary PcoMed technology (Treatment) for use in the spinal interbody and intervertebral market (Treated Products). PcoMed serves as the sole supplier of the Treatment. As consideration for the license and the Treatment, the Company paid to PcoMed initial milestone payments prior to the initial sale and the Company will pay PcoMed a low single digit royalty on the Company’s net sales of all Treated Products. In the event the Company fails to meet any of its payment obligations, the license will, at PcoMed’s option and following a cure period, convert to a non-exclusive license. The Supply Agreement contains customary representations and termination provisions, including for material breach and bankruptcy. Each of the Company and PcoMed retain the rights to their respective intellectual property. The Company's financial instruments that are exposed to concentrations of credit risk consist primarily of cash. Cash balances are maintained primarily at major financial institutions in the United States and exceed the regulatory limit of $250,000 insured by the Federal Deposit Insurance Corporation (FDIC). The Company has not experienced any credit losses associated with its cash balances.

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Significant Accounting Policies [Text Block]	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Use of Estimates Preparing consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent liabilities, and the reported amounts of revenues and expenses. Significant estimates affecting amounts reported or disclosed in the consolidated financial statements include allowances for doubtful accounts receivable and sales returns and other credits, net realizable value of inventories, discount rates and estimated projected cash flows used to value and test impairments of identifiable intangible and long-lived assets, assumptions related to the timing and probability of product launch dates, discount rates matched to the estimated timing of payments, probability of success rates and discount adjustments on the related cash flows for contingent considerations in business combinations, depreciation and amortization periods for identifiable intangible and long-lived assets, computation of taxes, valuation allowances recorded against deferred tax assets, the valuation of stock-based compensation and loss contingencies. These estimates are based on historical experience and on various other assumptions believed to be reasonable under the current circumstances. Actual results could differ from these estimates. The full extent to which the COVID-19 pandemic will directly or indirectly impact our business, results of operations and financial condition, including revenues, expenses, manufacturing, research and development costs and employee-related compensation, will depend on future developments that are highly uncertain, including as a result of new information that may emerge concerning COVID-19 and the actions taken to contain it or treat COVID-19, as well as the economic impact on local, regional, national and international customers and markets. We have made estimates of the impact of COVID-19 within our financial statements and there may be changes to those estimates in future periods. Actual results may differ from these estimates. Recent Accounting Standards Not Yet Adopted The Company qualifies as an “emerging growth company” (EGC) under the Jumpstart Our Business Startups (JOBS) Act and elected to take advantage of the extended transition period provided in Section 7(a)(2)(B) of the Securities Act of 1933, as amended, which permits EGCs to defer compliance with new or revised accounting standards until non-issuers must comply with such standards. Accordingly, so long as the Company continues to qualify as an EGC, the Company will not have to adopt or comply with new or revised accounting standards until non-issuers must adopt or comply with such standards. In June 2016, the FASB issued Accounting Standards Update (ASU or Update) No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , which requires credit losses on most financial assets measured at amortized cost, including trade receivables, and certain other instruments to be measured using an expected credit loss model, referred to as the current expected credit loss model. Under this model, entities will estimate credit losses over the entire contractual term of the instrument. The new standard will be effective for the Company beginning January 1, 2023. The FASB subsequently issued other related ASUs that amend ASU 2016-13 to provide clarification and additional guidance. The Company is evaluating the impact of this standard on its consolidated financial statements. In August 2018, the FASB issued Update No. 2018-15, Intangibles-Goodwill and Other-Internal Use Software (Subtopic 350-40) . The amendments in this Update align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software (and hosting arrangements that include an internal-use software license). The new standard will be effective for the Company beginning on January 1, 2021. Early adoption is permitted. The Company is evaluating the impact of this standard on its consolidated financial statements. In April 2019, the FASB issued Update No. 2019-04, Codification Improvements to Topic 326, Financial Instruments-Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments . This Update includes several amendments to the FASB Accounting Standards Codification (Codification) intended to clarify, improve, or correct errors therein. Some amendments do not require transition guidance and are effective upon issuance. The amendments requiring transition guidance have the same effective dates as Update No. 2016-13 and will be effective for the Company beginning on January 1, 2023. The Company is evaluating the impact of this standard on its consolidated financial statements. Recently Adopted Accounting Standards In February 2016, the FASB issued Update No. 2016-02, Leases (Topic 842) . The new standard requires lessees to recognize lease liabilities and corresponding right-of-use assets for all leases with lease terms of greater than twelve months. It also changes the definition of a lease and expands the disclosure requirements of lease arrangements. The new standard must be adopted using the modified retrospective approach. In July 2018, the FASB issued Update No. 2018-10, Codification Improvements to Topic 842 (Leases) and Update No. 2018-11, Leases (Topic 842): Targeted Improvements . In March 2019, the FASB issued Update No. 2019-01, Leases (Topic 842): Codification Improvements . In November 2019, the FASB issued Update No. 2019-10, Financial Instruments - Credit Losses (Topic 326), Derivatives and Hedging (Topic 815), and Leases (Topic 842): Effective Dates , which modifies the effective dates for Topic 842. The amendments in ASU 2018-10, ASU 2018-11, ASU 2019-01, and ASU 2019-10 provide additional clarification and implementation guidance on certain aspects of Topic 842 and have the same effective date and transition requirements as ASU 2019-10. The Company early adopted the new standard beginning on January 1, 2020. The Company adopted the new standard electing the optional transition method that allows for a cumulative-effect adjustment in the period of adoption and did not restate prior periods. The Company applied the transition package of practical expedients allowed by the standard. As a result of the Company’s adoption of the new standard, the Company recorded right-of-use assets and lease liabilities of $9.1 million and $10.5 million, respectively, for existing operating leases in the consolidated balance sheets at January 1, 2020. Additionally, the Company reversed $1.4 million of deferred rent liabilities previously recorded under the previous accounting guidance. The adoption of this new standard had no material impact on its consolidated results of operations or cash flows. In June 2018, the FASB issued Update No. 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting . This Update will require an entity to apply the requirements of Topic 718 to nonemployee awards except for specific guidance on inputs to an option pricing model and the attribution of cost (that is, the period of time over which share-based payment awards vest and the pattern of cost recognition over that period). The amendments specify that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in a grantor’s own operations by issuing share-based payment awards. The amendments also clarify that Topic 718 does not apply to share-based payments used to effectively provide (1) financing to the issuer or (2) awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under Topic 606. The new standard was effective for the Company beginning on January 1, 2020. The adoption of this new standard had no material impact on its consolidated financial statements. In August 2018, the FASB issued Update No. 2018-13, Fair Value Measurement (Topic 820)-Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement . The amendments in this Update modify the disclosure requirements on fair value measurements in Topic 820 based on the concepts in the Concepts Statement including the consideration of costs and benefits. The new standard was effective for the Company beginning on January 1, 2020. The adoption of this new standard had no material impact on its consolidated financial statements. In March 2020, the FASB issued Update No. 2020-04, Reference Rate Reform (Topic 848), Facilitation of the Effects of Reference Rate Reform on Financial Reporting. The amendments in this Update apply only to contracts, hedging relationships, and other transactions that reference LIBOR, or another reference rate expected to be discontinued, due to the reference rate reform. The new standard was effective for the Company beginning March 12, 2020. The adoption of this new standard had no material impact on its consolidated financial statements. Net Loss Per Share Basic and diluted net loss per share was calculated using the weighted-average number of shares of common stock outstanding during the period. The weighted average number of shares used to compute diluted net loss per share excludes any assumed exercise of stock options, any assumed issuance of common stock under restricted stock awards or units, and any assumed issuances under the Company's employee stock purchase plan, because the effect, in each case, would be antidilutive. Common stock equivalents of 4.1 million and 3.7 million shares for the three months ended March 31, 2020 and 2019 , respectively, were excluded from the calculation because of their antidilutive effect.

DEBT AND INTEREST

DEBT AND INTEREST	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Debt Disclosure [Text Block]	DEBT AND INTEREST Credit Agreement In December 2015, the Company entered into a three -year credit facility with Wells Fargo Bank, National Association, which was amended in October 2016 and in July 2018 (as amended, the Credit Facility). The Credit Facility provides an asset-backed revolving line of credit of up to $30.0 million with a maturity date of July 27, 2021, which is subject to a one-time, one -year extension at the Company's election. In addition, under the Credit Facility, at any time through July 27, 2020, the Company may increase the $30.0 million borrowing limit by up to an additional $10.0 million , subject to the Company having sufficient amounts of eligible accounts receivable and inventory and to customary conditions precedent, including obtaining the commitment of lenders to provide such additional amount. In connection with the Credit Facility, the Company was required to become a guarantor and to provide a security interest in substantially all its assets for the benefit of the counterparty. There were no amounts outstanding under the Credit Facility at March 31, 2020 or December 31, 2019. At March 31, 2020, the Company had $16.2 million of current borrowing capacity under the Credit Facility before the requirement to maintain the minimum fixed charge coverage ratio as discussed below. Debt issuance costs and legal fees related to the Credit Facility totaling $0.6 million were recorded as a deferred asset and are being amortized ratably over the term of the arrangement. Borrowings under the Credit Facility accrue interest at the rate then applicable to base rate loans (as customarily defined), unless and until converted into LIBOR rate loans (as customarily defined) in accordance with the Credit Facility. Borrowings bear interest at a floating annual rate equal to (a) during any month for which the Company's average excess availability (as customarily defined) is greater than $20.0 million , (i) base rate plus 1.25 percentage points for base rate loans and (ii) LIBOR rate plus 2.25 percentage points for LIBOR rate loans, (b) during any month for which the Company's average excess availability is greater than $10.0 million but less than or equal to $20.0 million , (i) base rate plus 1.50 percentage points for base rate loans and (ii) LIBOR rate plus 2.50 percentage points for LIBOR rate loans and (c) during any month for which the Company's average excess availability is less than or equal to $10.0 million , (i) base rate plus 1.75 percentage points for base rate loans and (ii) LIBOR rate plus 2.75 percentage points for LIBOR rate loans. The Company will also pay an unused line fee based on the average amount borrowed under the Credit Facility for the most recently completed month. If such average amount is 25% or greater of the maximum borrowing capacity, the unused fee will be equal to 0.375% per annum of the amount unused under the Credit Facility, and if such average amount is less than 25%, the unused line fee will be equal to 0.50% per annum of the amount unused under the Credit Facility. The unused line fee is due on the first day of each month. The Credit Facility contains various customary affirmative and negative covenants, including prohibiting the Company from incurring indebtedness without the lender’s consent. The Credit Facility also includes a financial covenant that requires the Company to maintain a minimum fixed charge coverage ratio of 1.10 to 1.00 for the applicable measurement period, if the Company's Total Liquidity (as defined in the Credit Facility) is less than $5.0 million . The Company was in compliance with all applicable covenants at March 31, 2020 . The Credit Facility also includes customary events of default, including events of default relating to non-payment of amounts due under the Credit Facility, material inaccuracy of representations and warranties, violation of covenants, bankruptcy and insolvency, failure to comply with health care laws, violation of certain of the Company’s existing agreements, and the occurrence of a change of control. Under the Credit Facility, if an event of default occurs, the lender will have the right to terminate the commitments and accelerate the maturity of any loans outstanding.

INVENTORIES

INVENTORIES	3 Months Ended
	Mar. 31, 2020
Inventory, Net [Abstract]
INVENTORIES	INVENTORIES Inventories consisted of: March 31, 2020 December 31, 2019 (In thousands) Finished goods $ 31,194 $ 30,042 Work in process 9,943 10,847 Raw materials 6,545 6,266 $ 47,682 $ 47,155

INVESTMENTS (Notes)

INVESTMENTS (Notes)	3 Months Ended
	Mar. 31, 2020
Investments, Debt and Equity Securities [Abstract]
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]	INVESTMENTS The amortized cost, estimated fair value and gross unrealized gains and losses on investments are shown in the table below: March 31, 2020 Amortized Cost Gross Unrealized Fair Value Gains (Losses) (In thousands) U.S. Treasury Bills $ 25,010 $ 190 $ — $ 25,200 As of March 31, 2020, the Company’s investment portfolio had no U.S. Treasury Bills in an unrealized loss position. There were no realized gains or losses during the three months ended March 31, 2020. As of December 31, 2019, there were no short-term investments.

PROPERTY, PLANT AND EQUIPMENT

PROPERTY, PLANT AND EQUIPMENT	3 Months Ended
	Mar. 31, 2020
Property, Plant and Equipment [Abstract]
PROPERTY, PLANT AND EQUIPMENT	PROPERTY, PLANT AND EQUIPMENT Property, plant and equipment are stated at historical cost less accumulated depreciation and amortization and any impairment charges. The Company provides for depreciation using the straight-line method over the estimated useful lives of the assets. Leasehold improvements are amortized over the lesser of the lease term or the useful life. The cost of major additions and improvements is capitalized, while maintenance and repair costs that do not improve or extend the lives of the respective assets are charged to operations as incurred. The cost of computer software obtained for internal use is accounted for in accordance with the Codification 350-40, Internal-Use Software. The cost of purchased spinal instruments which the Company consigns to hospitals and independent sales agents to support surgeries is initially capitalized as construction in progress. The amount is either then reclassified to spinal instruments and sets, and depreciation is initiated when instruments are put together in a newly built set with spinal implants, or directly expensed for the instruments used to replace damaged instruments in an existing set. The depreciation expense and direct expense for replacement instruments are recorded in selling and marketing expense. Property, plant and equipment balances and corresponding useful lives were as follows: March 31, 2020 December 31, 2019 Useful Lives (In thousands) Leasehold improvements $ 5,937 $ 5,878 Shorter of lease term or useful life Machinery and production equipment 8,712 8,562 3-10 years Spinal instruments and sets 28,216 25,511 4-5 years Information systems and hardware 7,498 7,442 3-7 years Furniture and fixtures 1,420 1,412 3-5 years Construction in progress 8,305 9,716 Total 60,088 58,521 Less accumulated depreciation and amortization (34,296 ) (32,770 ) Property, plant and equipment, net $ 25,792 $ 25,751 Depreciation and amortization expenses totaled $1.5 million and $1.1 million for the three months ended March 31, 2020 and 2019 , respectively. The cost of purchased instruments used to replace damaged instruments in existing sets and recorded directly to instrument replacement expense totaled $0.4 million and $0.5 million for the three months ended March 31, 2020 and 2019 , respectively. For the three months ended March 31, 2020 , the Company recorded impairment charges to selling and marketing expense totaling $0.2 million against spinal instruments that are no longer expected to be placed into service. Impairment charges against spinal instruments recorded for the three months ended March 31, 2019 were immaterial.

IDENTIFIABLE INTANGIBLE ASSETS

IDENTIFIABLE INTANGIBLE ASSETS	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
IDENTIFIABLE INTANGIBLE ASSETS	IDENTIFIABLE INTANGIBLE ASSETS Identifiable intangible assets are initially recorded at fair value at the time of acquisition, generally using an income or cost approach. The Company capitalizes costs incurred to renew or extend the term of recognized intangible assets and amortizes those costs over their expected useful lives. Primarily as a result of an expected shift in future product revenue mix more toward a parallel expanding interbody device designed based on the Company’s internally developed technology and, in turn, lower future revenue anticipated for the lordotic expanding implant based on technology the Company acquired from N.L.T. Spine Ltd. (NLT) and NLT Spine, Inc., a wholly owned subsidiary of NLT, the Company's estimated future net sales associated with those NLT Spine product technologies decreased. Accordingly, the Company evaluated the ongoing value of the product technology intangible assets associated with the acquisition of these assets. Based on this evaluation, the Company determined that intangible assets with a carrying amount of $1.6 million were no longer recoverable and were impaired, and the Company wrote those intangible assets down to their estimated fair value of $0.3 million at March 31, 2020. Significant estimates used in determining the estimated fair value include measurements estimating cash flows and determining the appropriate discount rate, which are considered Level 3 inputs under Codification 820. The components of the Company’s identifiable intangible assets were: March 31, 2020 Weighted Average Life Cost Accumulated Amortization Net (Dollars in thousands) Product technology 12 years $ 32,641 $ (29,015 ) $ 3,626 Customer relationships 12 years 56,830 (43,695 ) 13,135 Trademarks/brand names — 300 (300 ) — $ 89,771 $ (73,010 ) $ 16,761 December 31, 2019 Weighted Average Life Cost Accumulated Amortization Net (Dollars in thousands) Product technology 12 years $ 34,158 $ (28,912 ) $ 5,246 Customer relationships 12 years 56,830 (42,903 ) 13,927 Trademarks/brand names — 300 (300 ) — $ 91,288 $ (72,115 ) $ 19,173 Annual amortization expense (including amounts reported in cost of goods sold) is expected to be approximately $4.2 million in 2020 , $4.1 million in 2021 , $4.0 million in 2022 , $3.4 million in 2023 , and $ 1.5 million in 2024 . For the three months ended March 31, 2020 and 2019 , amortization expense totaled $1.1 million and $1.6 million , respectively, and included $0.3 million and $0.8 million , respectively, of amortization of product technology intangible assets that is presented within cost of goods sold.

FAIR VALUE MEASUREMENTS (Notes)

FAIR VALUE MEASUREMENTS (Notes)	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Disclosures [Text Block]	FAIR VALUE MEASUREMENTS The fair values of the Company’s assets and liabilities, including contingent consideration liabilities, are measured at fair value on a recurring basis, and are determined under the fair value categories as follows (in thousands): Total Quoted Price in Active Market (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) March 31, 2020: Short-term investments $ 25,200 $ 25,200 $ — $ — Contingent consideration liabilities- current $ 1,959 $ — $ — $ 1,959 Contingent consideration liabilities- non-current 86 — — 86 Total contingent consideration $ 2,045 $ — $ — $ 2,045 Total Quoted Price in Active Market (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) December 31, 2019: Short-term investments $ — $ — $ — $ — Contingent consideration liabilities- current $ 1,864 $ — $ — $ 1,864 Contingent consideration liabilities- non-current 230 — — 230 Total contingent consideration $ 2,094 $ — $ — $ 2,094 Short-term investments are classified with Level 1 of the fair value hierarchy because they use quoted market prices in active markets for identical assets. Under the terms of the 2016 asset purchase agreement between the Company and NLT, the Company is obligated to pay up to a maximum $5.0 million in milestone payments to NLT, payable at the Company's election in cash or in shares of its common stock. Such milestone payments are contingent on the Company's achievement of four independent events related to the commercialization of the product technologies the Company acquired in the transaction. Additionally, the Company must pay royalty payments, in cash, to NLT equal to declining (over time) percentages of the Company’s future net sales of certain of the acquired product technologies not to exceed $43.0 million in the aggregate. The Company has the option to terminate any future obligation to make royalty payments by making a one-time cash payment to NLT of $18.0 million . Contingent consideration liabilities are classified within Level 3 of the fair value hierarchy because they use significant unobservable inputs. For those liabilities, fair value is determined using a probability-weighted discounted cash flow model and significant inputs which are not observable in the market. The significant inputs include assumptions related to the timing and probability of the product launch dates, estimated future sales of the products, discount rates matched to the timing of payments, and probability of success rates. The following table sets forth the changes in the estimated fair value of the Company’s liabilities measured on a recurring basis using significant unobservable inputs (Level 3). The gain from change in fair value of contingent milestone and royalty payments resulted from updated estimated timing of payments, probability of success rates, the passage of time, updated discount rates matched to the estimated timing of payments, actual net sales of certain products for the three months ended March 31, 2020 , and estimated net sales for future royalty payment periods. A change in estimated timing of payments, probability of success rates, or estimated net sales for future royalty payment periods would be expected to have a material impact on the fair value of contingent milestone and royalty payments. Three Months Ended March 31, 2020: (in thousands) Balance as of January 1, 2020 $ 2,094 Contingent consideration liabilities settled (33 ) Gain from change in fair value of contingent consideration recorded in general and administrative expenses (16 ) Fair value at March 31, 2020 $ 2,045

EQUITY AND STOCK-BASED COMPENSA

EQUITY AND STOCK-BASED COMPENSATION	3 Months Ended
	Mar. 31, 2020
Share-based Payment Arrangement [Abstract]
STOCK-BASED COMPENSATION	EQUITY AND STOCK-BASED COMPENSATION Common Stock In January 2020, the Company entered into an Underwriting Agreement with Piper Sandler & Co. and Canaccord Genuity LLC relating to the issuance and sale of 6,800,000 shares of the Company’s common stock at a price to the public of $ 12.50 per share, before underwriting discounts and commissions. Under the terms of that agreement, the Company granted the underwriters an option, exercisable for 30 days, to purchase up to an additional 1,020,000 shares of common stock. The underwriters exercised this option and the offering closed on January 10, 2020 with the sale of 7,820,000 shares of common stock, resulting in net proceeds to the Company of approximately $ 91.6 million , after deducting underwriting discounts and commissions and estimated offering expenses payable by the Company. The offering was made pursuant to the Company’s shelf registration statement on Form S-3 that was declared effective on May 22, 2019. Equity Award Plans As of June 30, 2015, Integra had stock options, restricted stock awards, performance stock awards, contract stock awards and restricted stock units outstanding under three plans, the 2000 Equity Incentive Plan, the 2001 Equity Incentive Plan, and the 2003 Equity Incentive Plan. In connection with the spin-off, Integra equity awards granted to individuals who became employees of SeaSpine were converted to equity awards denominated in SeaSpine common stock. In general, each post-conversion award is subject to the same terms and conditions as were applicable to the pre-conversion award. In May 2015, the Company adopted the 2015 Incentive Award Plan, which was subsequently amended and restated with approval of the Company's stockholders. In February and March 2018, the Company's board of directors approved amendments to the plan that increased the share reserve by an aggregate of 2,726,000 shares over the then-existing share reserve thereunder, subject to stockholder approval. The Company's stockholders approved both amendments in May 2018 (the 2015 Incentive Award Plan, as amended and restated to date, the Restated Plan). Under the Restated Plan, the Company can grant its employees, non-employee directors and consultants incentive stock options and non-qualified stock options, restricted stock, performance stock, dividend equivalent rights, stock appreciation rights, stock payment awards and other incentive awards. The aggregate number of shares that may be issued or transferred pursuant to awards under the Restated Plan is the sum of (1) the number of shares issuable upon exercise or vesting of the number of Integra equity awards converted to the Company's equity awards under the Restated Plan as of the date of the spin-off and (2) 6,235,500 shares of its common stock in respect of awards granted under the Restated Plan. As of March 31, 2020 , 754,608 shares were available for issuance under the Restated Plan. On April 13, 2020, the Company's board of directors approved an amendment to the Restated Plan, pursuant to which (among other things) the share reserve will be increased by 3,500,000 shares, subject to stockholder approval. The Company is submitting this amendment to its stockholders for approval at its annual meeting of stockholders scheduled to be held on June 3, 2020. In 2016, the Company established the 2016 Employment Inducement Incentive Award Plan (the 2016 Plan), a broad-based incentive plan which allows for the issuance of stock-based awards, including non-qualified stock options, restricted stock awards, performance awards, restricted stock unit awards and stock appreciation rights, to those individuals and in those circumstances described below. An aggregate of 1,000,000 shares are reserved for issuance under the 2016 Plan. No awards have been granted under the 2016 Plan and as a result of the approval of the Restated Plan by the Company's stockholders in May 2018, the Company's board of directors will not grant any awards under the 2016 Plan in the future. In June 2018, the Company established the 2018 Employment Inducement Incentive Award Plan (the 2018 Inducement Plan). The terms of the 2018 Plan are substantially similar to the terms of the Restated Plan with these principal exceptions: (1) incentive stock options may not be granted under the 2018 Inducement Plan; (2) there are no annual limits on awards that may be issued to an individual under the 2018 Inducement Plan; (3) awards granted under the 2018 Inducement Plan are not required to be subject to any minimum vesting period; and (4) awards may be granted under the 2018 Inducement Plan only to those individuals and in those circumstances described below. An aggregate of 2,000,000 shares are reserved under the 2018 Inducement Plan. As of March 31, 2020, 1,906,337 shares were available for issuance under the 2018 Inducement Plan. If the amendment to the Restated Plan is approved by the Company's stockholders at the annual meeting of stockholders scheduled to be held on June 3, 2020, no awards will be granted under the 2018 Plan in the future. As a result, the only shares the Company would have available for issuance of equity awards (other than pursuant to the Company's employee stock purchase plan) would be the shares reserved for issuance under the Restated Plan, as amended. Both the 2016 Inducement Plan and the 2018 Inducement Plan were adopted by the Company’s board of directors without stockholder approval pursuant to Rule 5635(c)(4) of the Nasdaq Listing Rules. In accordance with Rule 5635(c)(4) of the Nasdaq Listing Rules, awards under those plans may only be made to an employee who has not previously been an employee or member of the Company's board of directors or of any board of directors of any parent or subsidiary of the Company, or following a bona fide period of non-employment by the Company or a parent or subsidiary, if he or she is granted such award in connection with his or her commencement of employment with the Company or a subsidiary and such grant is an inducement material to his or her entering into employment with the Company or such subsidiary. Forfeiture Rate Assumptions Stock-based compensation expense related to all equity awards includes an estimate for forfeitures. The expected forfeiture rate of all equity-based compensation is based on historical experience of pre-vesting forfeitures on awards and options by each homogeneous group of shareowners. For awards and options granted to non-executive employees, the forfeiture rate is estimated to be 14% annually for the three months ended March 31, 2020 and 13% annually for the three months ended March 31, 2019 . There is no forfeiture rate applied to awards or options granted to non-employee directors or executive employees because their pre-vesting forfeitures are anticipated to be highly unlikely. As individual awards and options become fully vested, stock-based compensation expense is adjusted to recognize actual forfeitures. Restricted Stock Awards and Restricted Stock Units Restricted stock award and restricted stock unit grants to employees generally have a requisite service period of three years, and restricted stock award and restricted stock unit grants to non-employee directors generally have a requisite service period of one year. Both are subject to graded vesting. The Company expenses the fair value of restricted stock awards and restricted stock units on an accelerated basis over the vesting period or requisite service period, whichever is shorter. No restricted stock units were granted to non-employee directors during the three months ended March 31, 2020 or 2019. No restricted stock awards were granted to non-employee directors during the three months ended March 31, 2020. During the three months ended March 31, 2019, restricted stock awards covering 11,840 shares were granted to non-employee directors. During the three months ended March 31, 2020 and 2019, 346,487 and 210,810 restricted stock units were granted to employees, respectively. No restricted stock awards were granted to employees during the three months ended March 31, 2020 or 2019. As of March 31, 2020 , there was approximately $5.3 million of unrecognized compensation expense related to the unvested portions of restricted stock awards and of restricted stock units. This expense is expected to be recognized over a weighted-average period of approximately 1.3 years . Stock Options Stock option grants to employees generally have a requisite service period of four years, and stock option grants to non-employee directors generally have a requisite service period of one year. Both are subject to graded vesting. The Company records stock-based compensation expense associated with stock options on an accelerated basis over the applicable vesting period within each grant and based on their fair value at the date of grant using the Black-Scholes-Merton option pricing model. There were 681,759 and 434,708 stock options granted during the three months ended March 31, 2020 and 2019, respectively. The following weighted-average assumptions were used in the calculation of fair value for options granted during the period indicated. Three Months Ended March 31, 2020 2019 Expected dividend yield — % — % Risk-free interest rate 1.6 % 2.5 % Expected volatility 43.8 % 30.3 % Expected term (in years) 3.0 2.9 The Company considered that it has never paid, and does not currently intend to pay, cash dividends. The risk-free interest rates are derived from the U.S. Treasury yield curve in effect on the date of grant for instruments with a remaining term similar to the expected term of the options. The expected volatility is calculated based upon the historical volatility of the Company's share prices. The expected term is calculated using the historical weighted average term of the Company’s options. As of March 31, 2020 , there was approximately $2.7 million of unrecognized compensation expense related to unvested stock options. This expense is expected to be recognized over a weighted-average period of approximately 1.8 years. Employee Stock Purchase Plan In May 2015, the Company adopted the SeaSpine Holdings Corporation 2015 Employee Stock Purchase Plan, which was amended in November 2018, as described below (as amended, the ESPP). Under the ESPP, eligible employees may purchase shares of the Company’s common stock through payroll deductions of up to 15% of eligible compensation during an offering period. Generally, each offering period will be for 24 months as determined by the Company's board of directors. There are four six-month purchase periods in each offering period for contributions to be made and to be converted into shares at the end of the purchase period. In no event may an employee purchase more than 2,500 shares per purchase period based on the closing price on the first trading date of an offering period or more than $25,000 worth of stock during any calendar year. The purchase price for shares to be purchased under the ESPP is 85% of the lesser of the market price of the Company's common stock on the first trading date of an offering period or on any purchase date during an offering period (June 30 or December 31). Subject to stockholder approval, on and effective as of November 2, 2018, the Company's board of directors approved an amendment to the ESPP pursuant to which the share reserve under the ESPP would increase from 400,000 shares to 800,000 shares. The Company's stockholders approved that amendment in May 2019. The ESPP is intended to qualify as an “employee stock purchase plan” within the meaning of Section 423 of the Internal Revenue Code of 1986, as amended (the IRC). The ESPP contains a restart feature, such that if the market price of the stock at the end of any six-month purchase period is lower than the market price at the original grant date of an offering period, that offering period will terminate after that purchase date, and a new two-year offering period will commence on the January 1 or July 1 immediately following the date the original offering period terminated. This restart feature was triggered on the purchase date that occurred on June 30, 2019, such that the offering period that commenced on January 1, 2019 was terminated, and a new two-year offering period commenced on July 1, 2019 and would end on June 30, 2021. This restart feature was triggered again on the purchase date that occurred on December 31, 2019, such that the offering periods that commenced on each of July 1, 2018 and July 1, 2019 were terminated, and a new two-year offering period commenced on January 1, 2020 and will end on December 31, 2021. The Company applied share-based payment modification accounting to the awards that were initially valued at the grant date to determine the amount of any incremental fair value associated with the modified awards. The impact to stock-based compensation expense for modifications during the three months ended March 31, 2020 was immaterial. No shares of common stock were purchased under the ESPP during the three months ended March 31, 2020 or 2019 . The Company recognized $0.2 million in expense related to the ESPP for each of the three months ended March 31, 2020 and 2019 . As of March 31, 2020, 280,462 shares were available under the ESPP for future issuance. The Company estimates the fair value of shares issued to employees under the ESPP using the Black-Scholes-Merton option-pricing model. The following weighted average assumptions were used in the calculation of fair value of shares under the ESPP at the grant date for the periods indicated: Three Months Ended March 31, 2020 2019 Expected dividend yield 0 % 0 % Risk-free interest rate 1.6 % 2.5 % Expected volatility 34.4 % 39.0 % Expected term (in years) 1.2 1.2

LEASES

LEASES	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Lessee, Operating Leases [Text Block]	10. LEASES The impact of the adoption of Topic 842 to the Company's applicable balance sheet items as of January 1, 2020 is presented in the table below. The standard did not have a material impact to the Company's unaudited condensed consolidated statements of operations or comprehensive loss or cash flows. (in thousands) December 31, 2019 Impact of Adoption of ASC 842 January 1, 2020 ASSETS Right of use assets $ — $ 9,059 $ 9,059 Total assets $ 141,718 $ 9,059 $ 150,777 LIABILITIES AND STOCKHOLDERS' EQUITY Current liabilities: Other accrued expenses and current liabilities 5,444 (138 ) 5,306 Current portion of operating lease liabilities — 2,080 2,080 Total current liabilities 30,478 1,942 32,420 Operating lease liabilities, net of current portion — 8,367 8,367 Other liabilities 1,250 (1,250 ) — Total liabilities $ 31,958 $ 9,059 $ 41,017 Total stockholders' equity $ 109,760 $ — $ 109,760 Total liabilities and stockholders' equity $ 141,718 $ 9,059 $ 150,777 The Company determines if an arrangement is a lease at inception. The Company's leases primarily relate to administrative, manufacturing, research, and distribution facilities and various manufacturing, office and transportation equipment. Lease assets represent the Company's right to use an underlying asset for the lease term and lease liabilities represent the obligation to make lease payments arising from the lease. Lease assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. As the Company's leases do not provide an implicit rate, the Company's incremental borrowing rate is used as a discount rate, based on the information available at the commencement date, in determining the present value of lease payments. Lease assets also include the impact of any prepayments made and are reduced by impact of any lease incentives. The Company made an accounting policy election for short-term leases, such that the Company will not recognize a lease liability or lease asset on its balance sheet for leases with a lease term of twelve months or less as of the commencement date. Rather, any short-term lease payments will be recognized as an expense on a straight-line basis over the lease term. The current period short-term lease expense reasonably reflects the Company's short-term lease commitments. The Company made a policy election for all classifications of leases to combine lease and non-lease components and to account for them as a single lease component. Variable lease payments are excluded from the lease liability and recognized in the period in which the obligation is incurred. Additionally, lease terms may include options to extend or terminate the lease when it is reasonably certain the Company will exercise the option. The Company’s lease portfolio only includes operating leases. As of March 31, 2020, the weighted average remaining lease term of these operating leases was 5.9 years and the weighted average discount rate was 6.5% . For the three months ended March 31, 2020, lease expense, which represents expense from operating leases, was $0.5 million . A summary of the Company's remaining lease liabilities at March 31, 2020 are as follows: Operating Leases (In thousands) 2020 2,300 2021 2,217 2022 2,237 2023 1,562 2024 1,368 Thereafter 3,277 Total undiscounted value of lease liabilities $ 12,961 Less: present value adjustment (2,201 ) Less: short-term leases not capitalized (701 ) Present value of lease liabilities 10,059 Less: current portion of lease liability (2,095 ) Operating lease liability, less current portion $ 7,964

INCOME TAXES

INCOME TAXES	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The following table summarizes the Company’s effective tax rate for the periods indicated: Three Months Ended March 31, 2020 2019 Reported income tax expense rate (0.3 )% (0.2 )% The Company recorded a provision for income tax expense for the three months ended March 31, 2020 primarily related to foreign and state operations. In addition, for all periods presented, the pretax losses incurred by the consolidated U.S. tax group received no corresponding tax benefit because the Company concluded that it is more likely than not that the Company will be unable to realize the value of any resulting deferred tax assets. The Company will continue to assess its position in future periods to determine if it is appropriate to reduce a portion of its valuation allowance in the future. On March 27, 2020, Congress enacted the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) to provide certain relief as a result of the COVID-19 pandemic. The CARES Act, among other things, includes provisions relating to net operating loss carryback periods, alternative minimum tax credit refunds, and modification to the net interest deduction limitations. The CARES Act did not have a material impact on our consolidated financial statements for the three months ended March 31, 2020. We continue to monitor any effects that may result from the CARES Act.

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	3 Months Ended
	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES In consideration for certain technology, manufacturing, distribution, and selling rights and licenses granted to the Company, the Company agreed to pay royalties on sales of certain products sold by the Company. Except for the royalties paid to NLT, the royalties the Company paid are included as a component of cost of goods sold in the consolidated statements of operations. The Company is subject to various legal proceedings in the ordinary course of its business with respect to its products, its current or former employees, and its commercial relationships, some of which have been settled by the Company. In the opinion of management, such proceedings are either adequately covered by insurance or otherwise indemnified, or are not expected, individually or in the aggregate, to result in a material adverse effect on the Company's financial condition. However, it is possible that the Company's results of operations, financial position and cash flows in a particular period could be materially affected by these contingencies. The Company accrues for loss contingencies when it is deemed probable that a loss has been incurred and that loss is estimable. The amounts accrued are based on the full amount of the estimated loss before considering insurance proceeds, and do not include an estimate for legal fees expected to be incurred in connection with the loss contingency. While uncertainty exists, the Company does not believe there are any pending legal proceedings that would have a material impact on the Company’s financial position, cash flows or results of operations.

SEGMENT AND GEOGRAPHIC INFORMAT

SEGMENT AND GEOGRAPHIC INFORMATION	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
SEGMENT AND GEOGRAPHIC INFORMATION	SEGMENT AND GEOGRAPHIC INFORMATION Segment Reporting Management assessed its segment reporting based on how it internally manages and reports the results of its business to its chief operating decision maker. Management reviews financial results, manages the business and allocates resources on an aggregate basis. Therefore, financial results are reported in a single operating segment: the development, manufacture and marketing of orthobiologics and of spinal implants. The Company reports revenue in two product categories: orthobiologics and spinal implants. Orthobiologics products consist of a broad range of advanced and traditional bone graft substitutes that are designed to improve bone fusion rates following surgery. The spinal implants portfolio consists of an extensive line of products for minimally invasive surgery, complex spine, deformity and degenerative procedures. The Company attributes revenues to geographic areas based on the location of the customer. The following table disaggregates revenue by major sales channel for each of the periods presented (in thousands): Three Months Ended March 31, 2020 United States International Total Orthobiologics $ 17,361 $ 2,260 $ 19,621 Spinal implants 14,452 2,038 16,490 Total revenue, net $ 31,813 $ 4,298 $ 36,111 Three Months Ended March 31, 2019 United States International Total Orthobiologics $ 17,038 $ 1,988 $ 19,026 Spinal implants 14,947 2,177 17,124 Total revenue, net $ 31,985 $ 4,165 $ 36,150

SUBSEQUENT EVENTS (Notes)

SUBSEQUENT EVENTS (Notes)	3 Months Ended
	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Events [Text Block]	SUBSEQUENT EVENTS In April 2020, the Company received an approximately $7.2 million loan under the Paycheck Protection Program of the CARES Act. The Company subsequently repaid $1.0 million of the loan and is awaiting further guidance from the U.S. Small Business Administration with respect to certain certifications the Company made in relation to the loan as to whether it will repay or retain the remaining balance.

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates Preparing consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent liabilities, and the reported amounts of revenues and expenses. Significant estimates affecting amounts reported or disclosed in the consolidated financial statements include allowances for doubtful accounts receivable and sales returns and other credits, net realizable value of inventories, discount rates and estimated projected cash flows used to value and test impairments of identifiable intangible and long-lived assets, assumptions related to the timing and probability of product launch dates, discount rates matched to the estimated timing of payments, probability of success rates and discount adjustments on the related cash flows for contingent considerations in business combinations, depreciation and amortization periods for identifiable intangible and long-lived assets, computation of taxes, valuation allowances recorded against deferred tax assets, the valuation of stock-based compensation and loss contingencies. These estimates are based on historical experience and on various other assumptions believed to be reasonable under the current circumstances. Actual results could differ from these estimates. The full extent to which the COVID-19 pandemic will directly or indirectly impact our business, results of operations and financial condition, including revenues, expenses, manufacturing, research and development costs and employee-related compensation, will depend on future developments that are highly uncertain, including as a result of new information that may emerge concerning COVID-19 and the actions taken to contain it or treat COVID-19, as well as the economic impact on local, regional, national and international customers and markets. We have made estimates of the impact of COVID-19 within our financial statements and there may be changes to those estimates in future periods. Actual results may differ from these estimates.
Recently Issued and Adopted Accounting Standards	Recent Accounting Standards Not Yet Adopted The Company qualifies as an “emerging growth company” (EGC) under the Jumpstart Our Business Startups (JOBS) Act and elected to take advantage of the extended transition period provided in Section 7(a)(2)(B) of the Securities Act of 1933, as amended, which permits EGCs to defer compliance with new or revised accounting standards until non-issuers must comply with such standards. Accordingly, so long as the Company continues to qualify as an EGC, the Company will not have to adopt or comply with new or revised accounting standards until non-issuers must adopt or comply with such standards. In June 2016, the FASB issued Accounting Standards Update (ASU or Update) No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , which requires credit losses on most financial assets measured at amortized cost, including trade receivables, and certain other instruments to be measured using an expected credit loss model, referred to as the current expected credit loss model. Under this model, entities will estimate credit losses over the entire contractual term of the instrument. The new standard will be effective for the Company beginning January 1, 2023. The FASB subsequently issued other related ASUs that amend ASU 2016-13 to provide clarification and additional guidance. The Company is evaluating the impact of this standard on its consolidated financial statements. In August 2018, the FASB issued Update No. 2018-15, Intangibles-Goodwill and Other-Internal Use Software (Subtopic 350-40) . The amendments in this Update align the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software (and hosting arrangements that include an internal-use software license). The new standard will be effective for the Company beginning on January 1, 2021. Early adoption is permitted. The Company is evaluating the impact of this standard on its consolidated financial statements. In April 2019, the FASB issued Update No. 2019-04, Codification Improvements to Topic 326, Financial Instruments-Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments . This Update includes several amendments to the FASB Accounting Standards Codification (Codification) intended to clarify, improve, or correct errors therein. Some amendments do not require transition guidance and are effective upon issuance. The amendments requiring transition guidance have the same effective dates as Update No. 2016-13 and will be effective for the Company beginning on January 1, 2023. The Company is evaluating the impact of this standard on its consolidated financial statements. Recently Adopted Accounting Standards In February 2016, the FASB issued Update No. 2016-02, Leases (Topic 842) . The new standard requires lessees to recognize lease liabilities and corresponding right-of-use assets for all leases with lease terms of greater than twelve months. It also changes the definition of a lease and expands the disclosure requirements of lease arrangements. The new standard must be adopted using the modified retrospective approach. In July 2018, the FASB issued Update No. 2018-10, Codification Improvements to Topic 842 (Leases) and Update No. 2018-11, Leases (Topic 842): Targeted Improvements . In March 2019, the FASB issued Update No. 2019-01, Leases (Topic 842): Codification Improvements . In November 2019, the FASB issued Update No. 2019-10, Financial Instruments - Credit Losses (Topic 326), Derivatives and Hedging (Topic 815), and Leases (Topic 842): Effective Dates , which modifies the effective dates for Topic 842. The amendments in ASU 2018-10, ASU 2018-11, ASU 2019-01, and ASU 2019-10 provide additional clarification and implementation guidance on certain aspects of Topic 842 and have the same effective date and transition requirements as ASU 2019-10. The Company early adopted the new standard beginning on January 1, 2020. The Company adopted the new standard electing the optional transition method that allows for a cumulative-effect adjustment in the period of adoption and did not restate prior periods. The Company applied the transition package of practical expedients allowed by the standard. As a result of the Company’s adoption of the new standard, the Company recorded right-of-use assets and lease liabilities of $9.1 million and $10.5 million, respectively, for existing operating leases in the consolidated balance sheets at January 1, 2020. Additionally, the Company reversed $1.4 million of deferred rent liabilities previously recorded under the previous accounting guidance. The adoption of this new standard had no material impact on its consolidated results of operations or cash flows. In June 2018, the FASB issued Update No. 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting . This Update will require an entity to apply the requirements of Topic 718 to nonemployee awards except for specific guidance on inputs to an option pricing model and the attribution of cost (that is, the period of time over which share-based payment awards vest and the pattern of cost recognition over that period). The amendments specify that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in a grantor’s own operations by issuing share-based payment awards. The amendments also clarify that Topic 718 does not apply to share-based payments used to effectively provide (1) financing to the issuer or (2) awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under Topic 606. The new standard was effective for the Company beginning on January 1, 2020. The adoption of this new standard had no material impact on its consolidated financial statements. In August 2018, the FASB issued Update No. 2018-13, Fair Value Measurement (Topic 820)-Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement . The amendments in this Update modify the disclosure requirements on fair value measurements in Topic 820 based on the concepts in the Concepts Statement including the consideration of costs and benefits. The new standard was effective for the Company beginning on January 1, 2020. The adoption of this new standard had no material impact on its consolidated financial statements. In March 2020, the FASB issued Update No. 2020-04, Reference Rate Reform (Topic 848), Facilitation of the Effects of Reference Rate Reform on Financial Reporting. The amendments in this Update apply only to contracts, hedging relationships, and other transactions that reference LIBOR, or another reference rate expected to be discontinued, due to the reference rate reform. The new standard was effective for the Company beginning March 12, 2020. The adoption of this new standard had no material impact on its consolidated financial statements.
Earnings Per Share	Basic and diluted net loss per share was calculated using the weighted-average number of shares of common stock outstanding during the period. The weighted average number of shares used to compute diluted net loss per share excludes any assumed exercise of stock options, any assumed issuance of common stock under restricted stock awards or units, and any assumed issuances under the Company's employee stock purchase plan, because the effect, in each case, would be antidilutive. Common stock equivalents of 4.1 million and 3.7 million shares for the three months ended March 31, 2020 and 2019 , respectively, were excluded from the calculation because of their antidilutive effect.

INVENTORIES (Tables)

INVENTORIES (Tables)	3 Months Ended
	Mar. 31, 2020
Inventory, Net [Abstract]
Schedule of Inventory, Net	Inventories consisted of: March 31, 2020 December 31, 2019 (In thousands) Finished goods $ 31,194 $ 30,042 Work in process 9,943 10,847 Raw materials 6,545 6,266 $ 47,682 $ 47,155

INVESTMENTS (Tables)

INVESTMENTS (Tables)	3 Months Ended
	Mar. 31, 2020
Investments, Debt and Equity Securities [Abstract]
Debt Securities, Available-for-sale [Table Text Block]	The amortized cost, estimated fair value and gross unrealized gains and losses on investments are shown in the table below: March 31, 2020 Amortized Cost Gross Unrealized Fair Value Gains (Losses) (In thousands) U.S. Treasury Bills $ 25,010 $ 190 $ — $ 25,200

PROPERTY, PLANT AND EQUIPMENT (

PROPERTY, PLANT AND EQUIPMENT (Tables)	3 Months Ended
	Mar. 31, 2020
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment	Property, plant and equipment balances and corresponding useful lives were as follows: March 31, 2020 December 31, 2019 Useful Lives (In thousands) Leasehold improvements $ 5,937 $ 5,878 Shorter of lease term or useful life Machinery and production equipment 8,712 8,562 3-10 years Spinal instruments and sets 28,216 25,511 4-5 years Information systems and hardware 7,498 7,442 3-7 years Furniture and fixtures 1,420 1,412 3-5 years Construction in progress 8,305 9,716 Total 60,088 58,521 Less accumulated depreciation and amortization (34,296 ) (32,770 ) Property, plant and equipment, net $ 25,792 $ 25,751

IDENTIFIABLE INTANGIBLE ASSETS

IDENTIFIABLE INTANGIBLE ASSETS (Tables)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Components of Company's Identifiable Intangible Assets	The components of the Company’s identifiable intangible assets were: March 31, 2020 Weighted Average Life Cost Accumulated Amortization Net (Dollars in thousands) Product technology 12 years $ 32,641 $ (29,015 ) $ 3,626 Customer relationships 12 years 56,830 (43,695 ) 13,135 Trademarks/brand names — 300 (300 ) — $ 89,771 $ (73,010 ) $ 16,761 December 31, 2019 Weighted Average Life Cost Accumulated Amortization Net (Dollars in thousands) Product technology 12 years $ 34,158 $ (28,912 ) $ 5,246 Customer relationships 12 years 56,830 (42,903 ) 13,927 Trademarks/brand names — 300 (300 ) — $ 91,288 $ (72,115 ) $ 19,173

FAIR VALUE MEASUREMENTS (Tables

FAIR VALUE MEASUREMENTS (Tables)	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis [Table Text Block]	The fair values of the Company’s assets and liabilities, including contingent consideration liabilities, are measured at fair value on a recurring basis, and are determined under the fair value categories as follows (in thousands): Total Quoted Price in Active Market (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) March 31, 2020: Short-term investments $ 25,200 $ 25,200 $ — $ — Contingent consideration liabilities- current $ 1,959 $ — $ — $ 1,959 Contingent consideration liabilities- non-current 86 — — 86 Total contingent consideration $ 2,045 $ — $ — $ 2,045 Total Quoted Price in Active Market (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) December 31, 2019: Short-term investments $ — $ — $ — $ — Contingent consideration liabilities- current $ 1,864 $ — $ — $ 1,864 Contingent consideration liabilities- non-current 230 — — 230 Total contingent consideration $ 2,094 $ — $ — $ 2,094
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	The following table sets forth the changes in the estimated fair value of the Company’s liabilities measured on a recurring basis using significant unobservable inputs (Level 3). The gain from change in fair value of contingent milestone and royalty payments resulted from updated estimated timing of payments, probability of success rates, the passage of time, updated discount rates matched to the estimated timing of payments, actual net sales of certain products for the three months ended March 31, 2020 , and estimated net sales for future royalty payment periods. A change in estimated timing of payments, probability of success rates, or estimated net sales for future royalty payment periods would be expected to have a material impact on the fair value of contingent milestone and royalty payments. Three Months Ended March 31, 2020: (in thousands) Balance as of January 1, 2020 $ 2,094 Contingent consideration liabilities settled (33 ) Gain from change in fair value of contingent consideration recorded in general and administrative expenses (16 ) Fair value at March 31, 2020 $ 2,045

EQUITY AND STOCK-BASED COMPEN_2

EQUITY AND STOCK-BASED COMPENSATION (Tables)	3 Months Ended
	Mar. 31, 2020
Share-based Payment Arrangement [Abstract]
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	Stock option grants to employees generally have a requisite service period of four years, and stock option grants to non-employee directors generally have a requisite service period of one year. Both are subject to graded vesting. The Company records stock-based compensation expense associated with stock options on an accelerated basis over the applicable vesting period within each grant and based on their fair value at the date of grant using the Black-Scholes-Merton option pricing model. There were 681,759 and 434,708 stock options granted during the three months ended March 31, 2020 and 2019, respectively. The following weighted-average assumptions were used in the calculation of fair value for options granted during the period indicated. Three Months Ended March 31, 2020 2019 Expected dividend yield — % — % Risk-free interest rate 1.6 % 2.5 % Expected volatility 43.8 % 30.3 % Expected term (in years) 3.0 2.9
Schedule of Share-based Payment Award, Employee Stock Purchase Plan, Valuation Assumptions [Table Text Block]	The Company estimates the fair value of shares issued to employees under the ESPP using the Black-Scholes-Merton option-pricing model. The following weighted average assumptions were used in the calculation of fair value of shares under the ESPP at the grant date for the periods indicated: Three Months Ended March 31, 2020 2019 Expected dividend yield 0 % 0 % Risk-free interest rate 1.6 % 2.5 % Expected volatility 34.4 % 39.0 % Expected term (in years) 1.2 1.2

LEASES (Tables)

LEASES (Tables)	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Schedule of New Accounting Pronouncements and Changes in Accounting Principles [Table Text Block]	The impact of the adoption of Topic 842 to the Company's applicable balance sheet items as of January 1, 2020 is presented in the table below. The standard did not have a material impact to the Company's unaudited condensed consolidated statements of operations or comprehensive loss or cash flows. (in thousands) December 31, 2019 Impact of Adoption of ASC 842 January 1, 2020 ASSETS Right of use assets $ — $ 9,059 $ 9,059 Total assets $ 141,718 $ 9,059 $ 150,777 LIABILITIES AND STOCKHOLDERS' EQUITY Current liabilities: Other accrued expenses and current liabilities 5,444 (138 ) 5,306 Current portion of operating lease liabilities — 2,080 2,080 Total current liabilities 30,478 1,942 32,420 Operating lease liabilities, net of current portion — 8,367 8,367 Other liabilities 1,250 (1,250 ) — Total liabilities $ 31,958 $ 9,059 $ 41,017 Total stockholders' equity $ 109,760 $ — $ 109,760 Total liabilities and stockholders' equity $ 141,718 $ 9,059 $ 150,777
Schedule of Future Minimum Rental Payments for Operating Leases [Table Text Block]	A summary of the Company's remaining lease liabilities at March 31, 2020 are as follows: Operating Leases (In thousands) 2020 2,300 2021 2,217 2022 2,237 2023 1,562 2024 1,368 Thereafter 3,277 Total undiscounted value of lease liabilities $ 12,961 Less: present value adjustment (2,201 ) Less: short-term leases not capitalized (701 ) Present value of lease liabilities 10,059 Less: current portion of lease liability (2,095 ) Operating lease liability, less current portion $ 7,964

INCOME TAXES (Tables)

INCOME TAXES (Tables)	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Schedule of effective income tax rate reconciliation	The following table summarizes the Company’s effective tax rate for the periods indicated: Three Months Ended March 31, 2020 2019 Reported income tax expense rate (0.3 )% (0.2 )%

BUSINESS Narrative (Details)

BUSINESS Narrative (Details)	3 Months Ended
	Mar. 31, 2020
Concentration Risk [Line Items]
Concentration Risk, Supplier	0.1

SUMMARY OF SIGNIFICANT ACCOUN_3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Narrative (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Accounting Policies [Abstract]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	4.1	3.7

DEBT AND INTEREST Credit Agreem

DEBT AND INTEREST Credit Agreement (Details)	Dec. 24, 2015USD ($)	Mar. 31, 2020USD ($)
Line of Credit Facility [Line Items]
Document Period End Date		Mar. 31, 2020
Credit Agreement [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Expiration Period	3 years
Line Of Credit Facility, Extension Period	1 year
Unamortized Debt Issuance Expense	$ 600,000
Debt Instrument, Covenant, Fixed Charge Ratio, Minimum	1.1
Debt Instrument, Covenant Description, Required Liquidity	$ 5,000,000
Credit Agreement [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	30,000,000
Line of Credit Facility, Remaining Borrowing Capacity		$ 16,200,000
Line of Credit Facility, Increase in Borrowing Capacity	$ 10,000,000
Credit Agreement, Contingent Interest Rate Three [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.75%
Credit Agreement, Contingent Interest Rate Three [Member] | London Interbank Offered Rate (LIBOR) [Member]
Line of Credit Facility [Line Items]
Debt Instrument, Basis Spread on Variable Rate	2.75%
Credit Agreement. Contingent Interest Rate Two [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.50%
Credit Agreement. Contingent Interest Rate Two [Member] | London Interbank Offered Rate (LIBOR) [Member]
Line of Credit Facility [Line Items]
Debt Instrument, Basis Spread on Variable Rate	2.50%
Credit Agreement, Contingent Interest Rate One [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.25%
Credit Agreement, Contingent Interest Rate One [Member] | London Interbank Offered Rate (LIBOR) [Member]
Line of Credit Facility [Line Items]
Debt Instrument, Basis Spread on Variable Rate	2.25%
Maximum [Member] | Credit Agreement [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Current Borrowing Capacity	$ 20,000,000
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	0.50%
Minimum [Member] | Credit Agreement [Member]
Line of Credit Facility [Line Items]
Line of Credit Facility, Current Borrowing Capacity	$ 10,000,000
Line of Credit Facility, Unused Capacity, Commitment Fee Percentage	0.375%

INVENTORIES Schedule of Invento

INVENTORIES Schedule of Inventories, net (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Inventory, Net [Abstract]
Finished goods	$ 31,194	$ 30,042
Work in process	9,943	10,847
Raw materials	6,545	6,266
Inventories, net	$ 47,682	$ 47,155

INVESTMENTS (Details)

INVESTMENTS (Details)	3 Months Ended
	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Investments, Debt and Equity Securities [Abstract]
Debt Securities, Available-for-sale, Unrealized Loss Position, Number of Positions	0
Debt Securities, Available-for-sale, Amortized Cost	$ 25,010,000
Debt Securities, Available-for-sale, Unrealized Gain	190,000
Debt Securities, Available-for-sale, Unrealized Loss	0
Short-term Investments	$ 25,200,000	$ 0

PROPERTY, PLANT AND EQUIPMENT P

PROPERTY, PLANT AND EQUIPMENT Property, plant and equipment balances (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Asset Impairment Charges	$ 234	$ 30
Depreciation	1,500	$ 1,100
Total	60,088		$ 58,521
Accumulated Depreciation, Depletion and Amortization, Property, Plant, and Equipment	(34,296)		(32,770)
Property, plant and equipment, net	25,792		25,751
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total	$ 5,937		5,878
Leasehold improvements | Minimum
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	1 year
Leasehold improvements | Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	20 years
Machinery and production equipment
Property, Plant and Equipment [Line Items]
Total	$ 8,712		8,562
Machinery and production equipment | Minimum
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	3 years
Machinery and production equipment | Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	10 years
Spinal instruments and sets
Property, Plant and Equipment [Line Items]
Total	$ 28,216		25,511
Spinal instruments and sets | Minimum
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	5 years
Spinal instruments and sets | Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	5 years
Information systems and hardware
Property, Plant and Equipment [Line Items]
Total	$ 7,498		7,442
Information systems and hardware | Minimum
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	3 years
Information systems and hardware | Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	7 years
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total	$ 1,420		1,412
Furniture and fixtures | Minimum
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	3 years
Furniture and fixtures | Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Lives (in years)	5 years
Construction in progress
Property, Plant and Equipment [Line Items]
Total	$ 8,305		$ 9,716

PROPERTY, PLANT AND EQUIPMENT N

PROPERTY, PLANT AND EQUIPMENT Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Property, Plant and Equipment [Line Items]
Depreciation	$ 1,500	$ 1,100
Instrument replacement expense	$ 379	$ 548

IDENTIFIABLE INTANGIBLE ASSET_2

IDENTIFIABLE INTANGIBLE ASSETS Asset Impairment Charges (Details)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Asset Impairment Charges [Text Block]	Primarily as a result of an expected shift in future product revenue mix more toward a parallel expanding interbody device designed based on the Company’s internally developed technology and, in turn, lower future revenue anticipated for the lordotic expanding implant based on technology the Company acquired from N.L.T. Spine Ltd. (NLT) and NLT Spine, Inc., a wholly owned subsidiary of NLT, the Company's estimated future net sales associated with those NLT Spine product technologies decreased. Accordingly, the Company evaluated the ongoing value of the product technology intangible assets associated with the acquisition of these assets. Based on this evaluation, the Company determined that intangible assets with a carrying amount of $1.6 million were no longer recoverable and were impaired, and the Company wrote those intangible assets down to their estimated fair value of $0.3 million at March 31, 2020. Significant estimates used in determining the estimated fair value include measurements estimating cash flows and determining the appropriate discount rate, which are considered Level 3 inputs under Codification 820.

IDENTIFIABLE INTANGIBLE ASSET_3

IDENTIFIABLE INTANGIBLE ASSETS Components of Company's Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Cost	$ 89,771	$ 91,288
Accumulated Amortization	(73,010)	(72,115)
Net	$ 16,761	$ 19,173
Product technology
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (in years)	12 years	12 years
Cost	$ 32,641	$ 34,158
Accumulated Amortization	(29,015)	(28,912)
Net	$ 3,626	$ 5,246
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Weighted Average Life (in years)	12 years	12 years
Cost	$ 56,830	$ 56,830
Accumulated Amortization	(43,695)	(42,903)
Net	13,135	13,927
Trademarks/brand names
Finite-Lived Intangible Assets [Line Items]
Cost	300	300
Accumulated Amortization	(300)	(300)
Net	$ 0	$ 0

IDENTIFIABLE INTANGIBLE ASSET_4

IDENTIFIABLE INTANGIBLE ASSETS Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Annual amortization expense expected to approximate in 2018	$ 4.2
Annual amortization expense expected to approximate in 2019	4.1
Annual amortization expense expected to approximate in 2020	4
Annual amortization expense expected to approximate in 2021	3.4
Annual amortization expense expected to approximate in 2022	1.5
Intangible asset amortization	1.1	$ 1.6
Technology-Based Intangible Assets [Member] | Cost of goods sold
Finite-Lived Intangible Assets [Line Items]
Intangible asset amortization	$ 0.3	$ 0.8

FAIR VALUE MEASUREMENTS Fair Va

FAIR VALUE MEASUREMENTS Fair Value Narrative (Details) $ in Millions	Sep. 26, 2016USD ($)
Milestone Payment [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	$ 5
Royalty payment [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	43
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, Low	$ 18

FAIR VALUE MEASUREMENTS Fair _2

FAIR VALUE MEASUREMENTS Fair Value on Recurring Basis (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Short-term Investments	$ 25,200,000	$ 0
Fair Value, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent Consideration Liability, Current, Fair Value Disclosure	1,959,000	1,864,000
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	86,000	230,000
Contingent Consideration Liability, Fair Value Disclosure	2,045,000	2,094,000
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Short-term Investments	25,200,000
Contingent Consideration Liability, Current, Fair Value Disclosure	0	0
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	0	0
Contingent Consideration Liability, Fair Value Disclosure	0	0
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Short-term Investments	0	0
Contingent Consideration Liability, Current, Fair Value Disclosure	0	0
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	0	0
Contingent Consideration Liability, Fair Value Disclosure	0	0
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Short-term Investments	0	0
Contingent Consideration Liability, Current, Fair Value Disclosure	1,959,000	1,864,000
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	86,000	230,000
Contingent Consideration Liability, Fair Value Disclosure	2,045,000	$ 2,094,000
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Purchases	$ 33,000

FAIR VALUE MEASUREMENTS Changes

FAIR VALUE MEASUREMENTS Changes in Contingent Consideration Liabilities (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term Investments	$ 25,200,000	$ 0
Fair Value, Recurring [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent Consideration Liability, Current, Fair Value Disclosure	1,959,000	1,864,000
Fair value of contingent consideration liability, beginning of period	2,094,000
Fair value of contingent consideration liability, end of period	2,045,000
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	86,000	230,000
Fair Value, Inputs, Level 1 [Member] | Fair Value, Recurring [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term Investments	25,200,000
Contingent Consideration Liability, Current, Fair Value Disclosure	0	0
Fair value of contingent consideration liability, beginning of period	0
Fair value of contingent consideration liability, end of period	0
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 3 [Member] | Fair Value, Recurring [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term Investments	0	0
Contingent Consideration Liability, Current, Fair Value Disclosure	1,959,000	1,864,000
Fair value of contingent consideration liability, beginning of period	2,094,000
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Purchases	(33,000)
Fair value of contingent consideration liability, end of period	2,045,000
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	86,000	230,000
Fair Value, Inputs, Level 2 [Member] | Fair Value, Recurring [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term Investments	0	0
Contingent Consideration Liability, Current, Fair Value Disclosure	0	0
Fair value of contingent consideration liability, beginning of period	0
Fair value of contingent consideration liability, end of period	0
Contingent Consideration Liability, Noncurrent, Fair Value Disclosure	0	$ 0
Selling, General and Administrative Expenses [Member] | Fair Value, Inputs, Level 3 [Member] | Fair Value, Recurring [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Gain (Loss) Included in Earnings	$ 16,000

EQUITY AND STOCK-BASED COMPEN_3

EQUITY AND STOCK-BASED COMPENSATION Common Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	Jan. 10, 2020	Mar. 31, 2020	Mar. 31, 2019
Stock Issued During Period, Shares, New Issues	7,820,000
Shares Issued, Price Per Share	$ 12.50
Proceeds from issuance of common stock, net of offering costs- ATM transactions	$ 91,600	$ 91,622	$ 0

EQUITY AND STOCK-BASED COMPEN_4

EQUITY AND STOCK-BASED COMPENSATION Equity Award Plans (Details) - shares	2 Months Ended
	Mar. 22, 2018	Mar. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized	2,726,000
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant		754,608
2015 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized		6,235,500
2016 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized		1,000,000
2018 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized		2,000,000
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant		1,906,337

EQUITY AND STOCK-BASED COMPEN_5

EQUITY AND STOCK-BASED COMPENSATION Restricted Stock Awards and Restricted Stock Units Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock Issued During Period, Shares, Restricted Stock Award, Gross	0	11,840
Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock Issued During Period, Shares, Restricted Stock Award, Gross	346,487	210,810
Restricted Stock Awards and Performance Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Forfeiture Rate	14.00%	13.00%
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount	$ 5.3
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition	1 year 3 months

EQUITY AND STOCK-BASED COMPEN_6

EQUITY AND STOCK-BASED COMPENSATION Stock Options Weighted-Average Assumptions (Details) - Share-based Payment Arrangement, Option [Member]	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate	0.00%	0.00%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	1.60%	2.50%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate	43.80%	30.30%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	3 years	2 years 11 months

EQUITY AND STOCK-BASED COMPEN_7

EQUITY AND STOCK-BASED COMPENSATION Stock Options Activity (Details) - Share-based Payment Arrangement, Option [Member] - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate	43.80%	30.30%
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross	681,759	434,708
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount	$ 2.7
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition	1 year 9 months
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	3 years	2 years 11 months
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate	0.00%	0.00%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	1.60%	2.50%

EQUITY AND STOCK-BASED COMPEN_8

EQUITY AND STOCK-BASED COMPENSATION Employee Stock Purchase Plan Weighted- Average Assumptions (Details) - Employee Stock Purchase Plan [Member]	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate	0.00%	0.00%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate	1.60%	2.50%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate	34.40%	39.00%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	1 year 2 months	1 year 2 months

EQUITY AND STOCK-BASED COMPEN_9

EQUITY AND STOCK-BASED COMPENSATION Employee Stock Purchase Plan Narrative (Details) - USD ($)	Jan. 10, 2020	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2018	Nov. 02, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock Issued During Period, Shares, New Issues	7,820,000
Shares Issued, Price Per Share	$ 12.50
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant		754,608
Employee Stock Purchase Plan [Member] | Employee Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee Stock Purchase Plan, Maximum Contributions Per Employee, Percent		15.00%
Share-based Compensation Arrangement by Share-based Payment Award, Maximum Number of Shares Per Employee		2,500
Employee Stock Purchase Plan, Maximum Annual Contributions Per Employee		$ 25,000
Employee Stock Purchase Plan, Stock Purchase Price, Percentage of Market Price		85.00%
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized				400,000	800,000
Share-based Payment Arrangement, Expensed and Capitalized, Amount		$ 200,000	$ 200,000
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant		280,462

LEASES Impact of Adoption Topic

LEASES Impact of Adoption Topic 842 (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Jan. 01, 2020	Dec. 31, 2019	Mar. 31, 2019	Dec. 31, 2018
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating Lease, Right-of-Use Asset	$ 8,710	$ 9,059	$ 0
Assets	227,727	150,777	141,718
Accrued Liabilities, Current	4,670	5,306	5,444
Operating Lease, Liability, Current	2,095	2,080	0
Liabilities, Current	29,788	32,420	30,478
Operating Lease, Liability, Noncurrent	7,964	8,367	0
Other Liabilities, Noncurrent	0	0	1,250
Liabilities	37,838	41,017	31,958
Stockholders' Equity Attributable to Parent	189,889	109,760	109,760	$ 133,179	$ 142,085
Liabilities and Equity	$ 227,727	150,777	$ 141,718
Accounting Standards Update 2016-02 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating Lease, Right-of-Use Asset		9,059
Assets		9,059
Accrued Liabilities, Current		(138)
Operating Lease, Liability, Current		2,080
Liabilities, Current		1,942
Operating Lease, Liability, Noncurrent		8,367
Other Liabilities, Noncurrent		(1,250)
Liabilities		9,059
Stockholders' Equity Attributable to Parent		0
Liabilities and Equity		$ 9,059

LEASES Lease Cost (Details)

LEASES Lease Cost (Details) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Lease, Cost [Abstract]
Operating Lease, Weighted Average Remaining Lease Term	5 years 11 months
Operating Lease, Weighted Average Discount Rate, Percent	6.50%
Operating Lease, Expense	$ 0.5

LEASES Operating lease annual p

LEASES Operating lease annual payment (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Jan. 01, 2020	Dec. 31, 2019
Operating Leased Assets [Line Items]
Lessee, Operating Lease, Liability, Payments, Due Next Twelve Months	$ 2,300
2021	2,217
2022	2,237
2023	1,562
2024	1,368
Thereafter	3,277
Total undiscounted value of lease liabilities	12,961
Less: present value adjustment	(2,201)
Operating Lease, Liability, Not Capitalized	(701)
Present value of lease liabilities	10,059
Less: current portion of lease liability	2,095	$ 2,080	$ 0
Operating lease liability, less current portion	$ 7,964	$ 8,367	$ 0

INCOME TAXES (Details)

INCOME TAXES (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Provision for income taxes	$ 35	$ 21
Reported tax rate (as a percent)	(0.30%)	(0.20%)

SEGMENT AND GEOGRAPHIC INFORM_2

SEGMENT AND GEOGRAPHIC INFORMATION Narrative (Detail)	3 Months Ended
	Mar. 31, 2020product
Segment Reporting [Abstract]
Number of product categories	2

SEGMENT AND GEOGRAPHIC INFORM_3

SEGMENT AND GEOGRAPHIC INFORMATION Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Revenues	$ 36,111	$ 36,150
United States
Segment Reporting Information [Line Items]
Revenues	31,813	31,985
International
Segment Reporting Information [Line Items]
Revenues	4,298	4,165
Orthobiologics
Segment Reporting Information [Line Items]
Revenues	19,621	19,026
Orthobiologics | United States
Segment Reporting Information [Line Items]
Revenues	17,361	17,038
Orthobiologics | International
Segment Reporting Information [Line Items]
Revenues	2,260	1,988
Spinal implants
Segment Reporting Information [Line Items]
Revenues	16,490	17,124
Spinal implants | United States
Segment Reporting Information [Line Items]
Revenues	14,452	14,947
Spinal implants | International
Segment Reporting Information [Line Items]
Revenues	$ 2,038	$ 2,177

SUBSEQUENT EVENTS (Details)

SUBSEQUENT EVENTS (Details) - USD ($) $ in Millions	3 Months Ended
	Jun. 30, 2020	Apr. 27, 2020
Subsequent Event [Line Items]
Notes Payable		$ 7.2
Repayments of Notes Payable	$ 1